AbstractsMedical & Health Science


The overall aim of this doctoral thesis was to explore videoconsultation as a working tool to increase accessibility to care in rural areas for residents, patients and healthcare personnel. This thesis consists of four studies, two with a qualitative approach (II, III), one with a quantitative approach (I) and one with mix methods (IV). In study II, focus group discussions were conducted with healthcare personnel at five primary healthcare centres aimed to describe their views on videoconsultation before the centres implemented the technology. The data were analysed with qualitative content analysis. In study I, a questionnaire was constructed to describe residents’ views on accessibility to specialist care and on using videoconsultation as a tool to increase the accessibility. Data was analysed with descriptive statistics. In study III, 26 patients who have participated in videoconsultation were interviewed about their experiences with specialists care via videoconsultation. The interviews were analysed with thematic content analysis. In study IV, individual interviews were conducted with eight general practitioners and one district nurse to have them describe their experiences of using videoconsultation in rural areas. Consultation reports were developed to give knowledge about technical functionality and the VC. These data were analysed with content analysis and, descriptive statistics respectively. The results show that a patient-centered videoconsultation was important. An advantage for the patient was reduced travels for specialist care but a disadvantage was not to have the opportunity to meet the specialist physician face to face. An important prerequisite for the patient to feel safe in videoconsultation was that the personnel be comfortable with the technology. The results also reveal that it was important to evaluate costs and personal recourses before implementing the technology (II). The respondents first chose to meet the specialist physician face to face and in second hand via videoconsultation with their general practitioner beside them. Videoconsultation was considered to save time, money and environment when patients did not have to travel (II, III). Residents felt secure when they were allowed to choose for themselves if they should participate in videoconsultation or receive a referral (III). Healthcare personnel considered that videoconsultation encounter were a useful opportunities for education and discussions with the specialist physician (IV). To conclude, videoconsultation increase the accessibility to specialist care for residents in rural areas. Although videoconsultation is considered important for the specialist care accessibility, participants thought that there was times when face-to-face meeting was to prefer. Distance videoconsultation saves time and money for the patient, the healthcare organization and the environment. Key words: videoconsultation, e-health, rural areas, nursing, primary healthcare, specialist care